Background:Papillectomy can be performed for benign and premalignant tumors of the ampulla of Vater (AOV) as an alternative to pancreaticoduodenectomy.However,the laparoscopic transduodenal papillectomy (LTDP) has rarely been attempted.Methods:From Sep 2010 to Dec 2012,LTDP were performed in three patients and one of them was underwent transumbilical single-incision LTDP (case C).The mean size of mass was 2.5cm (2.0-3.0cm).In the operation,after locating the tumor,we performed a longitudinal duodenotomy of approximately 1.0 cm first,which was a little low on the duodenum opposite the tumor and then lengthen it up or/and down to about 3.0-4.0cm just like a longitudinal dreich "S".And the reconstruction was also performed with incision at the same time all under laparoscopy.Results:LTDP was successful in the three patients.The mean operative time was 275 minutes (195-330min) and mean estimated blood loss was 240ml (100-400ml).Postoperative histology of case A and C was the same as adenoma while case B with moderately differentiated adenocarcinoma with mucus cell cancer.The complications happened only in one with mild pancreatitis and biliary fistula,which were cured after conservative management.Recurrences were only seen in case B six months after operation.Conclusions:Tranumbilical single-incision and four-port laparoscpoic transduodenal papillectomy were feasible and could be accomplished safety.